Rapid Response Events in the Critically Ill: A Case-Based Approach to Inpatient Medical Emergencies (Rapid Response Events in the Critically Ill, 3)

Careful monitoring of at-risk patients, early intervention, and timely escalation to the critical care unit from a general ward has been shown to improve patient clinical outcomes. The first text of its kind in this important area, Rapid Response Events in the Critically Ill: A Case-Based Approach to Inpatient Medical Emergencies is designed to help you recognize the fundamental signs of deterioration in patients on medical wards and ensure that transfer is made to the ICU before the development of adverse clinical outcomes. Using a highly effective teaching approach preferred by both residents and fellows, this innovative text links theory to practice with a brief review of clinical cases sourced from various academic centers. Presents 62 real-world clinical cases that demonstrate the principles of diagnosis and therapy, helping you develop a thorough understanding of how to diagnose and treat each condition. Provides practical clinical insights into the best methods to improve patient safety and quality of care through the rapid identification and clinical intervention of hospitalized patients suffering acute deterioration. Emphasizes how to identify and manage problems in a way that integrates theory and clinical experience. Cases contain an algorithmic flow chart for rapid decision-making reference, clinical pearls on diagnosis and management, and a consistent format for quick and easy access to key information. Front Cover Front Matter Copyright Dedicate Preface​ Acknowledgments​ Contributors​ Contents PART 1 Cases With Cardiovascular Pathologies 1 Chest Pain in a Patient With Coronary Artery Disease – I Case Study Vitals Signs Focused Physical Examination Interventions Generalized Approach to Acute Severe Chest Pain Acute Coronary Syndrome (ACS) Acute Aortic Dissection Pulmonary Embolism (PE) Pneumothorax Mediastinitis Pericardial Tamponade Suggested Approach to Chest Pain in a Rapid Response Setting Focused History and Physical Labs Electrocardiogram (EKG) Imaging Interventions Suggested Reading 2 Chest Pain in a Patient With Coronary Artery Disease – II Case Study Acute Coronary Syndrome Definition and Diagnosis Suggested Approach to a Patient With Suspected ACS Focused History and Physical Examination Laboratory Tests EKG Imaging Studies Therapeutic Interventions Summary of the Stepwise Approach for a Patient With Suspected ACS Coding a Patient with Cardiac Arrest from Acute Coronary Syndrome Suggested Reading 3 Chest Pain in a Patient With Hypertensive Emergency Case Study Vital Signs Focused Physical Exam Interventions Final Diagnosis Acute Aortic Dissection Suggested Approach to a Patient With Suspected Aortic Dissection Focused History and Physical Examination Laboratory Tests Electrocardiogram Imaging Studies Therapeutic Interventions Stepwise Approach to the Management of Suspected Acute Aortic Dissection Suggested Reading 4 Tachycardia in a Patient With Atrial Fibrillation Case Study Vital Signs Focused Physical Exam Interventions Final Diagnosis Atrial Fibrillation Suggested Approach to a Patient With Atrial Fibrillation and Rapid Ventricular Response in a Rapid Response Setting Focused History and Physical Examination EKG Laboratory Tests Imaging Therapeutic Interventions Stepwise Approach to the Management of a Patient with Ventricular Tachycardia Suggested Reading 5 Tachycardia in a Patient With Ischemic Cardiomyopathy Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Ventricular Tachycardia Suggested Approach to a Patient With Suspected Sustained VT Focused History and Physical Examination Laboratory Tests Electrocardiogram Imaging Therapeutic Interventions Summary of a Stepwise Approach to a Patient with VT Coding a Patient With VT Suggested Reading 6 Tachycardia in a Patient With Alcohol Withdrawal Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Supraventricular Tachycardia Definition and Diagnosis AV Nodal Re-entry Tachycardia (AVNRT) AV Re-entrant Tachycardia (AVRT) Atrial Tachycardia Other Suggested Approach to a Patient With Suspected SVT Focused History and Physical Examination EKG Laboratory Tests and Imaging Studies Therapeutic Management Summary of a Stepwise Approach to a Patient with Supraventricular Tachycardia Coding a Patient with Supraventricular Tachycardia Suggested Reading 7 Tachycardia in a Patient With Severe Pain Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Sinus Tachycardia Suggested Approach to a Patient With Suspected Sinus Tachycardia History and Physical Examination LABS EKG Imaging Therapeutic Interventions Summary of a Stepwise Approach to a Patient with Sinus Tachycardia Suggested Reading 8 Tachycardia and Hypotension in a Patient on Anticoagulation Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Shock Suggested Approach to a Patient With Non-Cardiogenic Shock History and Physical Examination Laboratory Testing Imaging Studies Therapeutic Interventions Suggested Reading 9 Bradycardia in a Patient With Atrial Fibrillation Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Bradycardia Definition and Diagnosis Suggested Approach to a Patient With Sinus Bradycardia Focused History and Physical Examination Laboratory Tests Electrocardiogram Imaging Studies Therapeutic Interventions Summary of a Stepwise Approach to a Patient with Bradycardia Coding a Patient with Bradycardia Suggested Reading 10 Bradycardia in a Patient With Myocardial Infarction Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Bradycardia – Heart Block After Myocardial Infarction Definition and Diagnosis Suggested Approach to a Patient With Sinus Bradycardia in the Setting of Myocardial Infarction Focused History and Physical Examination Laboratory Tests Electrocardiogram Imaging Studies Therapeutic Interventions Summary of a Stepwise Approach to a Patient with Bradycardia Coding a Patient with Bradycardia Suggested Reading 11 Bradycardia in a Patient With Heart Failure Case Study Vital Signs Focused Physical Examination Interventions Digoxin Toxicity Definition and Diagnosis Suggested Approach to a Patient With Suspected Digoxin Toxicity Focused History and Physical Examination Laboratory Tests Electrocardiogram Imaging Studies Therapeutic Interventions Summary of Steps to Approach a Patient with Digoxin Toxicity Coding a Patient with Cardiac Toxicity From Digoxin Suggested Reading 12 Hypotension in a Patient With Heart Failure Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Acute Cardiogenic Shock Pathophysiology Suggested Approach to a Patient With Cardiogenic Shock Focused History and Physical Exam Laboratory Testing EKG Imaging Studies Therapeutic Interventions Stepwise Approach to a Patient with Suspected Cardiogenic Shock Suggested Reading 13 Hypotension in a Patient With Myocardial Infarction Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Mechanical Complications After MI Pathophysiology Suggested Approach to a Patient With a Suspected Mechanical Complication of MI History and Physical Examination Laboratory Testing EKG Imaging Therapeutic Interventions Summary of a Stepwise Approach to a Patient With Hypotension and Chest Pain Following Mi and Suspicion of a Mechanical Comp ... Suggested Reading 14 Cardiac Arrest in a Patient With Pulseless Electrical Activity Case Study Vital Signs Focused Physical Exam Interventions Final Diagnosis Pulseless Electrical Activity Definition and Diagnosis Suggested Approach to a Patient With PEA/Asystole Focused History and Physical Examination Laboratory Testing Electrocardiogram Imaging Studies Therapeutic Interventions Suggested Readings 15 Cardiac Arrest in a Patient With Ventricular Fibrillation Case Study Vital Signs Focused Physical Exam Interventions Final Diagnosis Ventricular Fibrillation Suggested Approach to a Patient With VF Focused History and Physical Examination Laboratory Testing Electrocardiogram Imaging Studies Therapeutic Interventions Suggested Reading 16 Cardiac Arrest in a Patient With Torsades de Pointes Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Torsades de Pointes (TdP) Definition and Diagnosis Risk Factors Suggested Approach to a Patient With TdP Focused History and Physical Examination Laboratory Tests Electrocardiogram (EKG) Therapeutic Interventions Summary of a Stepwise Approach to a Patient with TdP Suggested Reading PART 2 Cases With Respiratory Pathologies 17 Tachypnea in a Patient With Severe Anemia Case Study Vital Signs Focused History and Physical Examination Interventions Final Diagnosis Tachypnea Suggested Approach to Tachypnea of Unknown Cause in a Rapid Response Setting Focused History and Physical Examination Laboratory Tests EKG Imaging Interventions Suggested Reading 18 Tachypnea in a Patient With Asthma Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Asthma Exacerbation Suggested Approach to a Patient With Suspected Asthma Exacerbation History and Physical Examination Laboratory Testing Imaging Therapeutic Interventions Stepwise Approach to the Management of a Patient with Suspected Asthma Exacerbation Coding a Patient with Asthma Exacerbation and Respiratory Arrest Suggested Reading 19 Tachypnea in a Patient After Hip Repair Surgery Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Pulmonary Embolism Definition Suggested Approach to a Patient With Suspected PE in a Rapid Response Event Focused History and Physical Examination Laboratory Tests EKG Imaging Risk Stratification Scores Therapeutic Interventions Summary of Approach to a Patient With Suspected PE in a Rapid Response Event Suggested Reading 20 Hypoxia in a Patient After Repair of Femoral Fracture Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Fat Embolism Syndrome Suggested Approach to a Patient With FES Focused History and Physical Examination Laboratory Tests EKG Imaging Studies Therapeutic Interventions Stepwise Approach to a Patient With FES Suggested Reading 21 Hypoxia in a Patient With No Cardiac or Pulmonary History Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Hypoxia/Hypoxemia Suggested Approach to a Patient With Hypoxia History and Physical Examination Laboratory Testing Imaging Therapeutic Interventions Suggested Reading 22 Acute Hypoxia in a Patient With Stroke Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Aspiration Pneumonia Suggested Approach to a Patient With Suspected Aspiration Focused History and Physical Exam Laboratory Testing Imaging Studies Therapeutic Interventions Stepwise Approach to a Patient with Suspected Aspiration Suggested Reading 23 Hypoxia in a Patient With Chronic Obstructive Pulmonary Disease (COPD) Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis COPD Exacerbation and CO2 Narcosis Suggested Approach to a Patient With Respiratory Failure Secondary to COPD Exacerbation Focused History and Physical Exam Laboratory Testing Imaging EKG Therapeutic Interventions Stepwise Approach to A Patient With Acute Respiratory Failure from Copd Exacerbation Suggested Reading 24 Hypoxia in a Patient With COVID-19 Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis COVID-19 Suggested Approach to a Patient With Acute Hypoxia From COVID-19 Focused History and Physical Examination Laboratory tests Imaging Studies Therapeutic Interventions Stepwise Approach to the Management of a Patient With COVID-19-Related Respiratory Failure Suggested Reading 25 Hypoxia in a Patient With Hypertensive Emergency Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Pulmonary Edema Suggested Approach to a Patient With Flash Pulmonary Edema Focused History and Physical Laboratory Tests Imaging Studies Electrocardiogram (EKG) Therapeutic Interventions Summary of a Stepwise Approach to Flash Pulmonary Edema Coding a Patient with Pulmonary Edema Suggested Reading 26 Hypoxia in a Patient With Bullous Emphysema Case Study Vital Signs Focused Physical Examination Working diagnosis Interventions Final Diagnosis Pneumothorax Suggested Approach to a Patient With Suspected Pneumothorax History and physical examination Laboratory Testing Imaging Therapeutic Interventions Stepwise Approach to a Patient with Acute Hypoxia from Suspected Pneumothorax Coding a Patient with Acute Respiratory Failure from Tension Pneumothorax Suggested Reading 27 Hypoxia in a Patient With Myasthenia Gravis Case Study Vital signs Focused physical examination Therapeutic interventions Final diagnosis Myasthenic Crisis Suggested Approach to a Patient With Respiratory Failure From Myasthenic Crisis Focused History and Physical Laboratory Tests Imaging Studies Therapeutic Interventions Summary of a Stepwise Approach to Patients with Suspected Myasthenia Crisis Suggested Reading 28 Hypoxia in a Patient With Sickle Cell Disease Case Study Vital Signs Focused Physical Examination Interventions Final diagnosis Acute Chest Syndrome Definition and Diagnosis Suggested Approach to a Patient With Suspected Acute Chest Syndrome Focused History and Physical Examination Laboratory Tests Imaging Studies Therapeutic Interventions Summary of Stepwise Approach a Patient with Suspected Acute Chest Syndrome Suggested Reading 29 Hypoxia in a Patient With Massive Pleural Effusion Case Study Vital Signs Focused Physical Examination Interventions Final diagnosis Massive Pleural Effusion Suggested Approach to a Patient With Hypoxic Respiratory Failure From Pleural Effusion Focused History and Physical Examination Laboratory tests Imaging Studies Procedures Therapeutic interventions Summary of a Stepwise Approach to a Patient with Massive Pleural Effusio Suggested Reading 30 Hypoxia in a Morbidly Obese Patient Case Study Vital signs Focused physical examination Interventions Final Diagnosis Obesity Hypoventilation Syndrome Pathophysiology Pulmonary function tests Imaging Studies Suggested Approach to a Patient With Suspected OHS With Acute Decompensation Focused History and Physical Exam Laboratory TestS Imaging Studies Ekg Therapeutic interventions Stepwise Approach to a Patient with Acute Respiratory Failure in the Setting of OHS Suggested Reading 31 Hypoxia in a Patient With Hemoptysis Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Hemoptysis Suggested Approach to a Patient With Massive Hemoptysis History and Physical Examination Laboratory Tests Imaging Studies Interventions Stepwise Approach to the Management of a Patient with Massive Hemoptysis Suggested Reading 32 Facial Swelling in a Patient After Bronchoscopy Case Study Vital Signs Focused Physical Examination Working Diagnosis Interventions Final Diagnosis Subcutaneous Emphysema Suggested Approach to a Patient With Suspected Subcutaneous Emphysema Focused History And Physical Laboratory Tests Imaging Studies Therapeutic Interventions Summary of Step-Wise Approach For Evaluation And Management Of Subcutaneous Emphysema Coding A Patient With Acute Hypoxic Respiratory Failure From Subcutaneous Emphysema Suggested Reading 33 Facial Swelling in a Patient With Penicillin Allergy Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Angioedema Definition and Diagnosis Suggested Approach to a Patient With Suspected Angioedema Focused History and Physical Examination Laboratory Testing Imaging Studies Therapeutic Interventions Summary of the Stepwise Approach of a Patient With Suspected Angioedema Coding a Patient With Angioedema Suggested Reading PART 3 Cases With Neurological Pathologies 34 Altered Mental Status of Unknown Cause Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Altered Mental Status Suggested Approach to a Patient With AMS Focused History and Physical Laboratory Tests EKG Imaging Studies Therapeutic Interventions Summary of Approach to a Patient With AMS in a Rapid Response Event Coding a Patient With AMS Suggested Reading 35 Altered Mental Status From Medication Adverse Effect Case Study Vital Signs Focused Physical Examination Interventions Diagnosis AMS From Medication Adverse Effect Suggested Approach to a Patient With AMS Secondary to Medication Adverse Effect Focused History and Physical Laboratory Testing EKG Imaging Studies Therapeutic Interventions Stepwise Approach to A Patient With Ams Because Of A Medication Side-Effect Suggested Reading 36 Altered Mental Status in a Patient With CNS Lymphoma Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Raised Intracranial Pressure Suggested Approach to a Patient With Suspected Raised ICP Focused History And Physical Examination Laboratory Tests EKg Imaging Studies Therapeutic Interventions Summary Of A Stepwise Approach To A Patient With Suspected Acute Elevation Of Icp Suggested Reading 37 Altered Mental Status in a Patient With Sepsis Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Septic Encephalopathy Definition Suggested Approach to a Patient With Encephalopathy in a Rapid Response Event Focused History and Physical Laboratory Tests Ekg Imaging Studies Therapeutic Interventions Summary Of Steps To Manage Encephalopathy In Hospital Coding A Patient With Septic Encephalopathy Suggested Reading 38 Altered Mental Status in a Patient With Substance Use Disorder Case Study Vital Signs Physical Examination Interventions Final Diagnosis Opioid Overdose Suggested Approach to a Patient With an Opioid Overdose in a Rapid Response Event Focused History And Physical LABoratory Tests Ekg Imaging Studies Therapeutic Interventions Stepwise Approach To A Patient With A Suspected Heroin Overdose In A Rapid Response Event Suggested Readings 39 Altered Mental Status in a Patient Transferred From ICU Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Delirium Suggested Approach to a Patient With AMS due to Delirium Focused History and Physical Laboratory Tests Imaging Studies Therapeutic Interventions Stepwise Approach to a Patient With AMS Because of Delirium in a Rapid Response Event Suggested Readings 40 Acute Vision Loss in a Patient With Eye Pain Case Study Vital Signs Physical Examination Interventions Final Diagnosis Acute Angle-Closure Glaucoma Suggested Approach to a Patient With AACG in a Rapid Response Event Focused History and Physical Examination Laboratory Tests Imaging Studies Special Tests (to Be Done by an Ophthalmologist On-Call or Emergency Department Physicians With Appropriate Training Therapeutic Interventions Stepwise Approach to a Patient With Suspected Angle-Closure Glaucoma Suggested Readings 41 Acute Vision Loss in a Patient With Atrial Fibrillation Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Ischemic Stroke Suggested Approach to a Patient With Suspected Acute Stroke Focused History and Physical Exam Laboratory Test Ekg Imaging Studies Therapeutic Interventions Stepwise Approach To A Patient With Suspected Acute Stroke Suggested Readings 42 Acute Onset Facial Droop Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Bell Palsy Definition And Diagnosis Suggested Approach to Acute Onset of Facial Droop in a Rapid Response Setting Focused History And Physical Laboratory Tests Ekg Imaging Studies Therapeutic Interventions Summary Of Approach To A Patient With A Facial Droop In A Rapid Response Event Suggested Readings 43 Loss of Consciousness in a Patient With Viral Gastroenteritis Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Syncope Suggested Approach to a Patient With Suspected Syncope Focused History And Physical Laboratory tests Ekg Imaging Studies Therapeutic Interventions Stepwise Approach To A Patient With Syncope In A Rapid Response Event Suggested Readings 44 Loss of Consciousness in a Patient With Seizure Disorder Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Non-Epileptiform Seizures Suggested Approach to a Patient With NES in a Rapid Response Event Focused History And Physical Examination Laboratory Tests Ekg Imaging Studies Therapeutic Interventions Stepwise Approach To A Patient With Nes Suggested Reading 45 Seizures in a Patient With Medication Non-Compliance Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Status Epilepticus Suggested Approach to a Patient With Status Epilepticus in a Rapid Response Event Focused History And Physical Examination Laboratory Tests Imaging Studies Therapeutic Interventions Stepwise Approach To Guide Management Of Status Epilepticus Suggested Reading 46 Seizures in a Patient With Hyponatremia Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Symptomatic Hyponatremia H Suggested Approach to a Patient With Hyponatremia in a Rapid Response Event Focused History And Physical Examination Laboratory Tests Imaging Studies Therapeutic Interventions Stepwise Approach For The Management Of Severe Symptomatic Hyponatremia Suggested Reading 47 Seizures in a Patient With New Hemodialysis Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Dialysis Disequilibrium Syndrome N Suggested Approach to a Patient With DDS in a Rapid Response Event Focused History And Physical Examination Laboratory Tests Imaging Studies Therapeutic Interventions Stepwise Approach To A Patient With Seizures In The Setting Of Dds Suggested Reading 48 Severe Headache in a Patient With Migraines Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Migraine Suggested Approach to a Patient With a Severe Headache Due to Migraine in a Rapid Response Event Focused History and Physical Examination Laboratory Tests Imaging Studies Therapeutic Interventions Stepwise Approach to a Patient with Migraine Headache in a Rapid Response Event Suggested Reading 49 Severe Headache in a Patient After Lumbar Puncture Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Post Lumbar Puncture Headache Suggested Approach to a Patient With PLPH in a Rapid Response Event Focused History and Physical Examination Laboratory Tests Imaging Studies Therapeutic Interventions Stepwise Approach to a Patient With a Plph in a Rapid Response Event Suggested Reading 50 Hyperthermia in a Patient on Polypharmacy Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Severe Hyperthermia Suggested Approach to a Patient With Severe Hyperthermia in a Rapid Response Event Focused History and Physical Examination Laboratory Tests EKG Imaging Studies Therapeutic Interventions Stepwise Approach to the Management of a Patient With Severe Hyperthermia in hospital Suggested Readings PART 4 Cases With Gastrointestinal Pathologies 51 Hematemesis in a Patient With Alcohol Use Disorder Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Upper Gastrointestinal Bleeding Suggested Approach to the Patient With Upper GI Bleed in a Rapid Response Setting Focused History and Physical Examination Laboratory tests Imaging Studies Therapeutic Interventions Stepwise Approach to the Management of a Patient with Large Volume Hematemesis Suggested Reading 52 Hematochezia in a Patient With Diverticulosis Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Acute Lower GI Bleed Suggested Approach to a Patient With Lower GI Bleed in a Rapid Response Setting Focused History and Physical Examination Laboratory Tests Imaging Studies Therapeutic Interventions Stepwise Approach to Patients With Acute Lower GI Bleed Suggested Readings 53 Acute Abdominal Pain in a Patient on High Dose Steroids Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Gastric/Duodenal Perforation Suggested Approach to a Patient With Suspicion of Perforated Gastric/Duodenal Ulcer Focused History and Physical Examination Laboratory Tests EKG Imaging Studies Therapeutic Interventions Stepwise Approach to Patients with Suspected Perforated Viscus Suggested Reading 54 Acute Abdominal Pain in a Patient With Atrial Fibrillation Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Acute Mesenteric Ischemia Definition and Diagnosis Suggested Approach to a Patient With Suspected AMI Focused History and Physical Exam Laboratory Workup Imaging Therapeutic Interventions Summary of Stepwise Approach in Patients With Suspected AMI Suggested Readings 55 Foreign Body Ingestion Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Foreign Body Ingestion Suggested Approach to a Patient With Suspected Foreign Body Ingestion History and Physical Examination Laboratory TestS Imaging Studies Therapeutic Interventions Stepwise Approach to a Patient Suspected of Foreign Body Ingestion Suggested Readings PART 5 Cases With Endocrinological Pathologies 56 Hypotension in a Patient With Adrenal Insufficiency Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Adrenal Crisis Suggested Approach to a Patient With an Adrenal Crisis in a Rapid Response Event Focused History and Physical Examination Laboratory Tests EKG Imaging Studies Therapeutic Interventions Summary of Steps to Manage Adrenal Crisis in Hospital Suggested Readings 57 Altered Mental Status in a Patient With Insulin-Dependent Diabetes Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Hypoglycemia Suggested Approach to a Patient With Hypoglycemia in a Rapid Response Event Focused History and Physical Examination Laboratory Studies EKG and Imaging Studies Therapeutic Interventions Suggested Readings 58 Hypotension in a Patient With Progressive Neurological Decline Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Myxedema Coma Suggested Approach to a Patient With Myxedema Coma in a Rapid Response Event Focused History and Physical Examination Laboratory Tests EKG Imaging Studies Therapeutic Interventions Summary of the Steps for the Management of Suspected Myxedema Coma in a Rapid Response Setting Suggested Reading 59 Tachycardia in a Patient on Amiodarone Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Thyrotoxicosis Suggested Approach to a Patient With Suspected Thyrotoxicosis Focused History And Physical Examination Laboratory Tests Ekg Imaging Studies Therapeutic Interventions Summary Of Steps For The Management Of Thyrotoxicosis In A Rapid Response Setting Suggested Reading 60 Muscle Spasms in a Patient With a History of Thyroidectomy Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Hypocalcemia Suggested Approach to a Patient With Hypocalcemia Focused History And Physical Examination Laboratory Tests Ekg Therapeutic Interventions Stepwise Approach To A Patient With Symptomatic Hypocalcemia Suggested Reading PART 6 Cases With Musculoskeletal Pathologies 61 Acute Foot Discoloration in a Patient With Peripheral Vascular Disease Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Acute Limb Ischemia Suggested Approach to a Patient With Suspected Acute Limb Ischemia Focused History And Physical Examination Laboratory Tests Ekg Imaging Studies Therapeutic Interventions Stepwise Approach To The Management Of Suspected Acute Limb Ischemia Suggested Reading 62 Acute Leg Pain in a Patient With Cellulitis Case Study Vital Signs Focused Physical Examination Interventions Final Diagnosis Acute Compartment Syndrome Suggested Approach to a Patient With Acute Compartment Syndrome Focused History And Physical Examination Laboratory Tests Imaging Studies Therapeutic Interventions Stepwise Approach To The Management Of Suspected Acute Compartment Syndrome Suggested Reading